Baby boomers, that population group born immediately after World War II, are determined to keep moving, no matter what living a full life has damaged. They are fueling a surge in joint replacements, according to a recent article in the Boston Globe. “Taking advantage of improved artificial joints and surgical methods, aging Americans are getting so many new hips, knees, shoulders, and ankles that orthopedic surgeons are having trouble meeting the demand.”

The article noted that hip replacements in the United States more than doubled between 2000 and 2014 — from 160,282 to 371,605 a year — according to the most recent data from the Healthcare Cost and Utilization Project, which tracks hospital discharges. Knee replacements increased at an even faster clip in the same period, from 274,467 to 680,886.

Dr. David Mattingly, who is quoted extensively in this article and is the surgeon in chief at New England Baptist Hospital, notes that this 60+ group wants to keep active and need good joints to do this.

Dr. Mattingly has a tie to the Dallas/Fort Worth area. “I did my fellowship at the New England Baptist Hospital in Boston and he was my mentor in my fellowship,” said Dr. Karim Elsharkawy, a joint replacement surgeon on the referral line at Texas Health Spine & Orthopedic Center.

The Texas Health Spine & Orthopedic Center Referral Line provides innovative ways for prospective joint replacement patients to get connected to participating physicians and in turn get advice on the procedures, as well as a customized care plan, which helps patients get on their path to recovery quickly and efficiently.

Why Are Baby Boomers Asking for Joint Replacement Procedures?

“There are multiple reasons that Baby Boomers are driving the increase in joint replacement to surgeries,” Dr. Elsharkawy said. “Some of the reasons relate to their desire to continue activities that this group is known for and part is due to the advances in the procedure over the years.

“Life expectancy has increased quite a bit over the past few decades and people are pursuing more active,healthy lifestyles. In the process, they are exerting a great deal of stress on their joints. Plus, not too many years ago, we would tell patients that a joint replacement would last them 15 to 20 years. Now, we have better implants and better components and we tell them that it will last them the rest of their lives.

“Patient expectations and our goals have changed over the years. Whereas, we once did joint replacement primarily to alleviate pain, now, with better outcomes and rapid recoveries, patients are getting back to active lifestyles including golfing, running and other sports.”

After joint replacements, some baby boomers expect to be able to do whatever activity they were doing when they were 30 year younger. Is this a reasonable expectation given the state of the procedure?

“It really depends on the joint,” Dr. Elsharkawy said. “Knees are different from hips in terms of recovery. This is just the nature of the joint.

“With a hip replacement, most patients ‘forget’ that they have had this joint replaced and they can pretty much do whatever they want to do after surgery. Knees respond differently due to the mechanics of the joint.

“If a patient was competing in ‘Ironman’ or marathon competitions when they were in their 30’s, they may not be able to compete at that same level, in their 60’s after a hip replacement but they can still be pretty active. However, knee replacements just feel differently. A patient will always be conscious of having had a knee replacement.

“Hip replacement has been called ‘The Operation of the Century’ by Lancet medical journal. Along with cataract surgery, the hip replacementprocedure has led to a remarkable improvement in the quality of life for patients.”

The 5 Factors that Help Improve Results from Joint Replacement

Dr. Elsharkawy pointed to five factors that will help improve outcomes after joint replacement surgery.

#1 Patients Should Have Reasonable Expectations

“Before the procedure, I spend considerable time with patients, discussing their goals and expectations from the procedure,” he said. “Some patients approach the surgery with goals that are not possible. For example, if a patient has hip and back pain. The hip replacement can help some with this back pain but it is not going to alleviate it completely. When a patient’s expectations are aligned with the realistic results from the procedure, optimal recovery is more likely.”

#2 Physical Therapy is Critical for Knee Replacement

“Strengthening the muscles in the knees with physical therapy after the procedure is extremely important,” Dr. Elsharkawy said. “Patients with weak quad muscles have a very hard time rehabbing their knee after the surgery. I tell my patients that my job (in surgery) takes about an hour and a half, the rest of the time is up to them and the physical therapists. If the muscle strength and joint mobility is not increased through physical therapy, just putting in a new knee joint will not help much.”

#3 Nutrition is Extremely Important for Recovery

“Proper nutrition can help wounds heal quicker and help to avoid infections,” Dr. Elsharkawy said. “Even patients who might be overweight before the procedure are often found to be malnourished. They are not getting the nutrients that they need and their protein levels are low. In some patients, we work on their nutrition before and after the procedure with supplements and protein shakes.”

#4 Other Medical Conditions Can Affect Patient Response to This Procedure

“Prior to surgery, we do blood work with our patients to help determine if they have other conditions that might pose the potential for complications,” he said. “If a patient is diabetic, getting his or her blood sugar under control is very important. Plus, if a patient is anemic or needs more iron before the surgery for faster recovery, we check this. Finally, if a patient is a smoker, there is an increase in the potential for complications from the surgery. Even if the patient is not going to stop smoking forever, we request that they stop 6 to 8 weeks before the procedure.”

#5 Motivation is Key

“Many articles have been published recently on the effects of positive motivation,” Dr. Elsharkawy said. “In my own experience, I have found that patients who are motivated to feel better and have a positive attitude about the procedure, have better outcomes than those who don’t. So, before the procedure, we work with the patient to get in a positive state of mind.”

If you’re considering a joint replacement, contact our patient navigators to connect with participating physicians who can customize a care plan for you.

Physicians who are members of the referral program practice independently and are not employees or agents of Texas Health Spine & Orthopedic Center.